Repurposing Molecular Imaging and Sensing for Cancer Image-Guided Surgery

Area of Science:

• Oncology
• Medical Imaging
• Surgical Science

Background:

• Medical imaging has evolved from solely visualizing anatomy to revealing molecular and pathophysiologic processes.
• Molecular imaging (MI), exemplified by 18F-FDG PET, significantly enhances cancer detection, heterogeneity assessment, treatment monitoring, and image-guided interventions.
• Surgeons increasingly utilize advanced medical imaging for comprehensive cancer care, from preoperative planning to postoperative assessment.

Purpose of the Study:

• To review the current landscape of molecular imaging and sensing technologies for surgical guidance.
• To discuss the strengths, limitations, and clinical applications of nuclear, optical, and multimodal imaging approaches in surgery.
• To provide a framework for selecting appropriate imaging contrast mechanisms, modalities, and devices for surgical guidance.

Main Methods:

• Review of current molecular imaging and sensing technologies relevant to surgical guidance.
• Discussion of nuclear, optical, and multimodal imaging techniques.
• Analysis of imaging agent advancements and technological improvements.

Main Results:

• Molecular imaging offers enhanced accuracy in tumor detection, characterization, and response monitoring.
• Image-guided surgery provides surgeons with macroscopic and microscopic views of cancer, improving precision.
• A framework is proposed for selecting imaging contrast mechanisms, modalities, and devices.

Conclusions:

• Molecular imaging and sensing technologies are transforming surgical oncology by providing unprecedented visualization.
• Emerging low-cost, portable imaging systems show promise for widespread adoption in surgical practice.
• These advancements are paving the way for new global standards of care in image-guided surgery.